Pathway to Being a Culturally Competent Nurse

Nursing is quite often regarded as a science itself and many who are already in the field of nursing seek cultural knowledge and awareness to improve their professional skills. The creation of new professional competency is made possible through a number of factors such as changes in the education system, advancement in technology, employment requirements and many more. Globalization and cultural changes require culturally competent professionals able to meet patients’ needs and expectations.

The importance of a cultural element in nursing profession is tremendous, because it helps to improve service delivery and communication, planning and ethical decision-making. The major points of analysis will deal with cultural competency of a nurse and its impact on healthcare delivery, the requirements one must meet in the hospital and in nursing school. A special attention will be paid to cultural self- assessment and cultural client assessment as a part of healthcare service. Cultural Competency

There is a number of speculations and criticism behind the establishment of cultural nursing practice, but generally a lot of potential promises have been seen from this profession. “The process of cultural competency consists of 5 interrelated constructs: cultural desire, cultural awareness, cultural knowledge, cultural skill, and cultural encounters; the key — pivotal construct is cultural desire” (Cultural Competency 2005). The role of culturally competent nurse within the health care delivery system is an important one, whether assessed in terms of in or out patient care, of hospital or community care settings.

Cultural globalization is one of the main factors which influence healthcare profession and demands new communication patterns for effective organisational performance. Following Dreher and Macnaughton (2002): “the health care system has nested the accountability for cultural competency with the clinician who provides direct services to individuals, where the application of cultural information is likely to be least useful” (181). In general, cultural diversity manifests in the values, attitudes, and motivations of patients and their expectations.

In this case, the balance of power has undoubtedly shifted to nurses who have more choice over how to conducts relationships with their administration, colleagues and patients. The main ethical principle related to this subject is moral values which stipulate behavior of employees. Moral values are a per¬son’s fundamental orientation toward life, what a nurse sees as right and wrong. Ethical responsibilities of a nurse are how decisions and actions show con¬cern for what is considering fair and just. Medical ethics mean more than simply passing moral judgment about what should and should not be done in a particular situa¬tion.

It is part of the conscious decisions a practitioner makes about the directions and consequences of his decisions (Leininger, McFarland 2002). It is a link between morality, responsibility, and decision making based on cultural differences and knowledge of unique values and beliefs followed by patients. The main effect of cultural competency can be explained by increasing importance of cultural diversity influences on the environment and perspectives of further development on the macro- and micro- level.

In this situation, to be a professional nurse, it is necessary to exercise the role of leadership based on cultural knowledge and expertise. A common view is that the job requires the ability of cultural communication and that leadership is in effect a sub-set of management. In terms of cultural competency, there is a need to be flexible and be ready to innovate and to adopt new technologies as they come along. The way in which healthcare organization has to employ cultural approach and communication is a part of competitive advantage.

The advantages of cultural communication in nursing are fast response to changing conditions, environment and ability to apply cultural knowledge into practice. This approach increases confidence of nurses and level of healthcare services in general. Using this approach, nurses are able to shift the situation applying new creative methods of communication based on advanced relationships and inquiry. “Dr. Campinha-Bacote described her practice model of cultural competency as a volcano.

At the base, there must be a true desire to be culturally competent” (Cultural Competency 2005). Today, a hospital is influenced by resources outside the healthcare organization which are an integral part of the chain of activities between the healthcare service design and the level of medical treatment. In this case, detailed resource planning and deployment are important ingredients in the successful implementation of cultural competency. This has speeded up health delivery processes, transformed working practices and increased the efficiency of healthcare services.

Interestingly, it is in the technological environment that it is some¬times possible for large healthcare organizations to actually exert influence rather than be the recipients of it (Dreher, Macnaughton 2002). Also, cultural competency in nursing is concerned with those activities involved in recruiting of professional staff, training, and development within the healthcare infrastructure, namely the systems of planning, finance, medical service control, etc. which are crucially important to a strategic capability in all healthcare activities.

The main ethical requirements in this field involve valuing diversity and cultural knowledge (Fawcett, 2002). Nursing School is an environment which influences values and ethical principles of nurses, their cultural competency and knowledge. To achieve cultural competency, cultural sensitivity and the ability to incorporate strategies to enhance the cross cultural teaching and learning experience will become increasingly necessary as the cultural diversity of students and clients continues to grow. The individuals participating in an interaction do not intend there to be misunderstanding, yet it is often inevitable.

For this reason, it is crucial to include cultural principles and teaching of cultural skills in curriculum (Leininger, McFarland 2002). The main responsibilities of students are to acquire knowledge and skills important for effective cultural communication. They are responsible for improving quality of services and think about the large nursing practices which involve development of the unique personal approach to cultural competency. Medical students should provide the continuing dialogue with peers and teaching staff, and obtain knowledge of biological differences.

Also, students need to acquire a foreign language in order to improve cultural communication and awareness of unique cultural values of national minorities. The USA is a culturally diverse country and, for this reason, healthcare organizations start to apply cultural competency into practice seeing it as a high level of specialist practice and competitive advantage. Today, a special attention is given to proper function of medical staff and empowerment which helps to improve efficiency of medical practices and introduce technological innovation more rapidly and effectively.

Critics admit that the really worrying thing about such situations is that there are many nurses who have become used to the conditions in which poor practice prevails and, being habituated to a health care culture of unquestioning obedience, they fail to recognize that anything is wrong. Sometimes, the combination of unthinking conformist behavior on the part of nurses and a compliant or apprehensive posture on the part of the patient can be fatal (Leininger, McFarland 2002).

Nurses and other health careers should be taking new initiatives in linking up with patient groups to find mechanisms of public accountability: patient’s committees, members’ groups at day centers, health councils, and so on. Cultural self-assessment and clients’ assessment should be the core of professional communication and development. One value of self-assessment is to close the gap between self-perception and actual behavior. Self-assessment includes analysis of personal beliefs and cultural awareness, cultural communication patterns and analysis of the social environment.

The process can also be used to identify some of the major gaps in cultural competency which have to be solved by training (Leininger, McFarland 2002). Every nurse should take into account cultural environment in order to inspire and empower enthusiasm in others. Nursing values involve psychosocial, spiritual and physical factors of care. Clients’ assessment includes analysis and evaluation of their religious beliefs and cultural patterns of behavior which affected communication with medical staff and treatment.

The nurses are both psychological and physical caregivers, and human values such as compassion and concern based on cultural knowledge should be the main priority in this profession. Dealing with different patients, it is crucial to take into account his cultural and religious differences which affect communication and human interaction. Differences in cultural treatment of women and men are important element of clients’ assessment. Thus, the implications of cultural competency in healthcare are twofold. First, nurses must be extremely cautious in the way they apply cultural knowledge into practice.

Second, in dealings with patients from other cultures nurses must recognize that differences do exist and be prepared to adjust behavior and expectations accordingly. This is the theme of many recent initiatives in training for nurses. In culturally diverse society, social norms and values are likely to have been transmitted by previous gen¬erations through the process of socialization such as family influence and formal education (Galambos et al 2006). Conclusion In sum, the US healthcare industry cannot exist without experienced nurses and this might be particularly true especially for multicultural environment.

Nurses are the backbone of the industry and, thus, it should be equated that a strong backbone is required for the integrity of the industry. Professionalism is all about work and anything that is taken personally should be shrugged off. For this reason, a nurse should create environment which supports recovery of a patient and decreases feelings of insecurity or insult caused by cultural differences. References 1. Cultural Competency: An Integral Part of Holistic Nursing Practice (2005). Retrieved 19 Feb 2007 from http://www. medscape. com/viewarticle/513607

2. Dreher, N. , Macnaughton, N. (2002). Cultural competency in nursing: foundation or fallacy? Nursing Outlook, Sep-Oct; 50 (5):181-6. 3. Galambos, C. , Vourlekis, B. , Zlotnik, J. (2006). Improving Psychosocial Care in Nursing Home Settings: The Next Challenge. Health and Social Work, 31 (2), 83. 4. Fawcett, J. (2002). The Nurse Theorists: 21st-Century Updates—Madeleine M. Leininger. Nursing Science Quarterly, 15 (2): 131-136. 5. Leininger, M. M. , ; McFarland, M. (2002). Trancultural nursing: Concepts, theories, research, and practices. 3rd edn. McGraw-Hill.